Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatobiliary cancer after hepatocellular carci-noma (HCC). Surgical resection is the main curative treatment for ICC. Patients with ICC exhibit poorer prognosis compared with those with HCC. A comprehensive individualized prognostic system must be developed based on specific factors of patients. Several distinct prognostic staging systems have been proposed for patients with ICC treated by surgery. These systems include six staging systems, two scoring systems, and three prognostic nomograms. However, all of these prognostic systems are based on data from patients un-dergoing surgery resection and have not been validated in patients receiving other therapies. In this review, we will discuss the prog-nostic accuracy and applicability of current available prognostic systems and provide directions for future investigations.

Objective To compare their antipyretic effect of diclofenac suppository (diclofenac) and injectio amidopyrini compositae (amidopyrin) in the treatment for surgical infection with high fever. Methods One hundred patients suffering from surgical infection with high fever were randomly divided into two groups: 50 cases in diclofenac group (50 mg with rectal administration) and 50 cases in amidopyrin group (2 ml, with intramuscular injection) , and their antipyretic effects were observed. Results The antipyretic effect of diclofenac (with an overall effective rate of 96% ) was better than that of amidopyrin (82% ), with a P-value less than 0.05, and their remarkably effective rates were 82% and 58% for the two groups, respectively, with a P-value less than P

Total Glucosides of Paeony Root ( TGPs, 5-40 mg/kg) had a dose-related increasing effect on the survival time of mice under normobaric hypoxia. TGPs (20 mg/kg) had a significant increasing effect on survival time of mice under hypobaric hypoxia & a decreasing effect in the oxygen consumption in mice. TGPs ( 40mg/kg ) decreased the mortality of mice from the acute hypoxia induced by KCN. Increasing effect on the survival time of mice under normobaric hypoxia of TGPs was significantly antagonised by chlortrimeton. The efficacy of TGPs (icv 2.5-5 mg/kg) approximated to that of TGPs (ip 5-40 mg/kg) respectively. It suggested that the effect of TGPs on resistance to hypoxia was produced by central nervous system. The efficacy of TGPs ( icv) was significantly antagonised by chlortrimeton. It was shown that the effect of TGPs was produced by H1-receptor. In the experiment of resistance to hypoxia of TGPs (ip or icv), we measured the change of rectal temperature of mice. The data indicated the positive corr- elation of both effects of TGPs (r=0.58, P

BACKGROUND:It remains controversial in term of therapeutic efficacy of self-fixating mesh and sutured mesh in inguinal hernia repair. OBJECTIVE:To compare the therapeutic effects of self-fixating mesh and sutured mesh in open inguinal hernia repair with Meta-analysis. METHODS:Comprehensive electronic search strategies were developed using the folowing electronic databases: Cochrane library, PubMed, EMBASE, Medline, Ovid, CNKI, Wanfang and FMJS. The Literature published before December 2014 was searched. Perspective randomized controled trials about comparing self-fixating mesh and sutured mesh in open inguinal hernia repair were included. A data-extraction sheet was developed based on the preset standards. The data from eligible studies were pooled through Meta-analysis. RESULTS AND CONCLUSION:Nine trials with a total of 2 100 inguinal hernia patients met the inclusion criteria, including 1 033 cases of self-fixing mesh and 1 067 cases of sutured mesh. The Meta-analysis showed that no significant differences were found between the two groups in the recurrence rate, seroma, hematoma, wound infection, pain, foreign body sensations (P > 0.05), but the duration of operation was less in the self-fixing mesh group than the sutured mesh group (P < 0.05). According to limited evidence, there are some findings as folows: self-fixating mesh is equivalent to sutured mesh in the therapeutic effects on open inguinal hernia repair. Because of the limits of samples and literature quality, more large-sample and high-quality trials are required to make a definite clinical evidence to use self-fixating mesh for groin hernia repair.

BACKGROUND:It remains controversial in term of efficacy for the lightweight mesh and heavyweight mesh in inguinal hernia repair.
OBJECTIVE:To compare the clinical therapeutic effects of lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair with Meta-analysis.
METHODS:Comprehensive electronic search strategies were developed using the fol owing electronic databases:PubMed, Cochrane Library, EMBASE, Medline, Ovid, CNKI, VIP, Wanfang and FMJS. The Literature published before February 2013 was searched. The randomized control ed trials about comparing lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair were included. A data-extraction sheet was developed based on the preset standards. The data from eligible studies were pooled using RevMan5.1 software through Meta-analysis.
RESULTS AND CONCLUSION:Eighteen trials with a total of 4 450 hernias met the inclusion criteria. The meta-analysis showed that there was a statistical difference between lightweight mesh group and the heavyweight mesh group on short-term pain [odd ratio (OR)=0.57, 95%confidence interval (CI) (0.43, 0.74), P<0.05] and a reduced risk of developing foreign body sensations [OR=0.49, 95%CI (0.35, 0.69), P<0.05]. No significant differences were found between the two groups in recurrence rate, testicular atrophy, seroma, hematoma, wound infection, urine retention (P>0.5). According to limited evidence, there are some findings as fol ows:the lightweight mesh is of feasibility, safety and effectiveness for inguinal hernia repair. Because of the limits of sample and quality, more large-sample and high-quality trials are required to make a definite clinical evidence to use lightweight mesh for inguinal hernia repair.

Objective To compare the efficacies of da Vinci robotic and traditional laparoscopic resection for colorectal cancer.Methods Databases including Pubmed,Cochrane Library,EMBASE,Medline,Wanfang,CNKI,VIP and FMJS were searched,and literatures published before February 2012 were retrieved.Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) focusing the comparison between da Vinci robotic and laparoscopic resection for colorectal cancer were collected.All the literatures retrieved were screened according to preset standards,and the patients were divided into robotic group and laparoscopic group.A meta analysis on the effectiveness of robotic and laparoscopic surgery for colorectal cancer was carried out using the RevMan 5.1 software.Categorical variables were presented by odds ratio (OR) and 95％ confidence interval (95 ％ CI),continuous variables were presented by weighted mean difference (WMD) and 95 ％ CI.Results One RCT and 10 NRCTs including 974 patients with colorectal cancer were screened out and there were 426 patients in the robotic group and 548 patients in the laparoscopic group.Compared with conventional laparoscopic surgery,longer operation time,lower rate of conversion to laparotomy and shorter anal exsufflation time were observed in the robotic group (WMD =25.61,OR =0.32,WMD =-0.21,P ＜ 0.05).There were no significant differences in the operative blood loss,number of lymph node dissected,distal resection margin,morbidity and duration of hospital stay between the robotic group and the laparoscopic group (WMD =-23.14,-0.31,0.14,OR =1.06,WMD =-0.43,P ＞ 0.05).Conclusion The efficacies of da Vinci robotic and laparoscopic surgery for the treatment of colorectal cancer are comparable,while da Vinci robotic surgery has the features of lower rate of conversion to laparotomy and shorter anal exsufflation time.

Interventional management was performed in 10 patients with hemorrhage following hepatic biliary and pancreatic surgery.The super-selection arterial embolization was performed in 9 patients using gelfoam pledgets (n =6 ) or metal coils (n =3 ),the procedure was combined with local infusion of reptilase; 1 case was managed by local infusion of reptilase alone.Selective angiography revealed the pseudoaneurysm in 3 cases,contrast media extravasation in 6 cases; in 1 case no obvious bleeding site was found The interventional treatment was successful and hemorrhage stopped in all patients,including one case with reptilase alone with a successful rate of 10/10.The results indicate that interventional treatment is a safe and effective method for hemorrhage following hepatic biliary and pancreatic surgery.

Objective To investigate the effects of spleen preservation on hepatic fibrosis and relevant cytokine in rabbits with advanced schistosomiasis. Methods After hepatic cirrhosis was induced by infecting Schistosoma japonicum cercariae in rabbits, total splenectomy (TSG), subtotal splenectomy (SSG) or sham operation (model control group, MCG) were performed respectively on these rabbits. Meanwhile,a normal control group (NCG) was established. The serum levels of tumor necrosis factor alpha (TNF-α) , interleukin-6 (IL-6) and interleukin-1 beta (IL-lβ) were detected respectively by radioimmunoassay(RIA) at the 8th, 15th and 21st week post-infection. The expressions of transforming growth factor betal (TGF-β1), type Ⅰ and type Ⅲ collagen in liver tissues were determined by immunohistochemistry before and after the operations. Results Compared with NCG, the serum levels of TNF-α, IL-6 and IL-1β of MCG rabbits increased significantly at the 8th week post-infection (P <0.01). However, the levels of them decreased to a lower level at the 15th week. At the 6th week after operation,no significant difference was found among the three model groups ( MCG, TSG, SSG) (P > 0.05). The expressions of TGF-β1, type Ⅰ and type Ⅲ collagen in liver tissue of MCG rabbits were significantly higher than those of NCG rabbits before the operation (P < 0. 01). No significant difference was found among the three model groups at the 6th week after the operation ( P > 0.05). Conclusion The residual splenic tissue after subtotal splenectomy does not aggravate the hepatic fibrosis at advanced schistosomiasis. The mechanism may be that the relevant cytokines of hepatic fibrosis (TGF-β1, TNF-a, IL-6, IL-1β) decreased to a lower level at this time,and splenectomy does not influence the levels of them.

AIM: To observe the curative efficacy of Shenkang Bolt(SKB) in treating chronic renal failure(CRF) with blood silt and damp pathogen syndrome. METHODS: The randomized,parallel and controlled trial were used.38 cases in treatment group were treated with SKB,and 40 cases in control group were clystered with Chinese herbal medicine.The changes of the cumulative scores of traditional Chinese medicine(TCM) syndrome,the levels of serum creatinine(SCr) and creatinine clearance rate(CCr) before and after treatment in both groups were observed. RESULTS: The total effective rate was 81.5% in the treatment group,but 75% in the control group.The scores of TCM syndrome and the levels of SCr were both significantly decreased(P(0.05)). CONCLUSION: SKB can markedly improve the clinical manifestations of CRF with blood silt and damp pathogen syndrome,decrease the levels of SCr,but increase CCr.There was no difference between Chinese herbal clysis and Shenkang Bolt in curative effect,but it is convenent to take Shenkang Bolt.

Objective To explore the imaging diagnostic value of primary ureter carcinoma.Methods Intravenous or retrograde pyelography was performed in 21 cases.Ultrasound(US)examination was performed in 25 cases.CT scan was performed in 14 cases.Results The manifestations of the intravenous and retrograde pyelography of the ureter carcinoma were irregular filling defect. The US revealed the various sized, irregular solid node , the tumor protruding into the bladder cavity. The CT displayed as various sized , different density , irregular soft mass . Conclusion The intravenous and retrograde pyelography combine with US , CT , the diagnostic level of ureter carcinoma can be increased .